Direct care worker bill drawing mixed reviews

Unlike plumbers, barbers and massage therapists, Iowa's 73,000 direct care workers - many of whom work on their own to provide in-home care - aren't subject to a professional oversight board.

Some groups are calling for a change to professionalize Iowa's largest workforce through legislative action, but others say the bill would duplicate existing regulations.

A bill under consideration in the Legislature would establish core state standards for training, create career pathways for specialization and form a board to oversee those professional standards.

These workers provide a variety of assistance, with bathing or applying medicated ointment, for example, for Iowa's aging population.

“What's great about this program is the standardization of it,” said Kim Foltz, executive director of Iowa Alliance in Home Care, which represents the home health industry.

She said home health agencies now provide training for new employees, regardless of how long the worker had been employed elsewhere. The change would allow those workers to carry their credentials from job to job, standardize training for employees and assure home care patients and employers that an employee is properly trained in that core set of competencies, she said.

Training would be both curriculum-based and hands-on, Foltz said, but it should be available under a variety of settings.

Kelly Meyers, director of regulatory and government affairs for the Iowa Health Care Association and Iowa Center for Assisted Living, said the association is among several opposed to the bill. She said the bill would add unnecessary costs for workers who are already certified nursing assistants with 75 hours of mandated training.

“It's a different layer of regulatory oversight, but they call it licensure,” she said, adding that cuts to Medicare and Medicaid will make the move more difficult to fund. “It would be in addition to what we already have to do.”

Executive Director Di Findley of the Iowa CareGivers Association, which also supports the measure, noted that certified nursing assistants would be grandfathered into the new system.

“The current system creates tremendous barriers for CNAs, Home Care Aides, Hospice Aides and others because their training is so fragmented and inconsistent,” she wrote in an email. “In many cases their education and training won't follow them from one setting to another.”

Findley said that while there will be costs to establish the new system, “the glaring costs that we should all be concerned about are those associated with the high turnover among this sector of the workforce.”

The cost of the 65 percent average annual turnover rate in 2011 was $189 million, she wrote, and “Those dollars can be better spent by investing in this vital workforce by providing them the education, skills, compensation, and professional status they deserve.”

During a news conference on the bill Wednesday in Des Moines, AARP Iowa State Director Kent Sovern urged Iowa's lawmakers to pass the bill. He said the demand for direct care services is growing and the state will need an additional 12,000 such workers by 2012.

FYI:

“Empowered to Care” is a 5 minute video that features the voices of workers who are calling for state educational standards.  

http://www.training-source.org/direct-care-interviews/